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Permit (78) CITY OF TIGARD MASTER PERMIT s t COMMUNITY DEVELOPMENT Permit#: MST2016-00416 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 WI/Ma Date Issued: 11/08/2016 Parcel: 2S109DD08400 Jurisdiction: Tigard Site address: 12797 SW DA VINCI LN Subdivision: BELLA VISTA Lot: 14 Project: HUNEKE Project Description: Conversion of existing crawl space to habitable space. 1/9/2.017: REPRINT permit to correct converted space from 267 sf to 322 sf. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 0 sf Basement: 267 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Yes Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Total: 322 sf Value: $125,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Drains: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: sump pump MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'I 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 10 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 322 Owner: Contractor: HUNEKE,PATRICK JOSEPH&SHAHIN NEIL KELLY CO INC Required Items and Reports(Conditions) 12797 SW DAVINCI LN 804 N ALBERTA ST TIGARD,OR 97224 PORTLAND,OR 97217 PHONE: PHONE: 503-288-7461 FAX: Total Fees: $3,116.84 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through 952-001-0091. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: d�c Permittee Signature: zi/t/ 7. --71-Pe.-761... %7CJ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Oh CITY OF TIGARD MASTER PERMIT F. COMMUNITY DEVELOPMENT Permit#: MST2016-00416 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/08/2016 Parcel: 2S109DD08400 Jurisdiction: Tigard Site address: 12797 SW DA VINCI LN Subdivision: BELLA VISTA Lot: 14 Project: HUNEKE Project Description: Conversion of existing crawl space to habitable space. BUILDING Floor Areas Required Setbacks Required Stories: 1 Bedrooms: 1 First: 0 sf Basement: 267 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 1 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 1 Third: 0 sf Right: 0 Detectors: Yes Total: 267 sf Value: $125,000.00 Rear: 0 PLUMBING Sinks: 1 Water Closets: 1 Washing Mach: Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 1 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 Drains: 0 Tubs/Showers: 1 Garbage Disp: 0 Water Heaters: 1 Water Lines: 0 Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: sump pump MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 1 Clothes Dryers: 0 Natural Gas Heat Pump: N Hoods: 0 Other Units: 1 Fum<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=10OK: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add'l 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 10 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 267 Owner: Contractor: HUNEKE,PATRICK JOSEPH&SHAHIN NEIL KELLY CO INC Required Items and Reports(Conditions) 12797 SW DAVINCI LN 804 N ALBERTA ST TIGARD,OR 97224 PORTLAND,OR 97217 PHONE: PHONE: 503-288-7461 FAX: Total Fees: $3,116.84 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for • - the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are et forth , OAR 952-001-0010 through OAR 9 '90. You may obtain a copy of the rules or direct questions to OUNC by calling 'ao 32.1987 or 1.800.332.23,4. ("" 7 Issued By: ---3 Permittee Signature: �A.,-— ' �,.„.�►- Call 503.639.4175 by 7:00 a.m.for the next available inspectio. •ate. This permit card shall be kept in a conspicuous place on the job site until co pletion of the proj I. Approved plans are required on the job site at the time of each inspection. Building Permit Application Residential FOR OFFICE USE ONE)" City of Tigard % RETTJ' .N"` o ii it.? , / Permit No.: 3r I , - >' .114 "t 13125 SW Hall Blvd.,Tigard,OR 97223 I Phone: 503.718.2439 Fax: 503.598.1960 Plan Review i ateB 0 $ other Permit : Inspection Line: 503.639.4175 D�.11. 2 I ate Read B Juris: i IGARD Ready/By: � H See Page 2for Internet: www.tigard-or.gov Notified/Method: Au � Supplemental Information CITY OFT'. " ❑New construction ❑Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all [ ddition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the s t work indicated on this application. 1. 1-and 2-family dwellingValuation: $ OOQ ❑Commercial/industrial / 0 Accessory building ❑Multi-family Number of bedrooms: ❑Master builder ❑Other: Number of bathrooms: Job site address: • 4! • 'A - New dwelling area:3TOPV'/square feet-"`F;rs-- ! City/State/ZIP: -p CAI 97`I o,z4 Garage/carport area: (� " square feet .� Suite/bldg./apt.no.: �l Projecttname:� 111.4 '", �, Covered porch area: square feet Cross street/directions to job site: ....51//) %4f',F�4 1 Pifr VE Deck area: square feet T Other structure area: square feet Subdivision: I Lot no.: /4 Permit fees*are based on the value of the work performed. Tax map/parcel no.: = Indicate the value(rounded to the nearest dollar)of all �' �� u equipment,materials,labor,overhead,and the profit for the t €- � � � �a�„r�'�a y � '� � work indicated on this application. NVf1(5/01V 61 EX/S A/4 C e./G 5fiiic To A Valuation: $ $�5�fiE/Vr ,57 )P/ems /3/P77/. NGti �/l/W 4 a) Existing building area: square feet / , AS, Ate / New building area: square feet . u ` �'� ,". � r Number of stories: Name: A 7—Pe/Cf f c 5H-Ail/A/ //,/g/1‹e Type of construction: Address: Occupancy groups: City/State/ZIP: Existing: Phone:( ) Fax:( ) New: 6 Business name: /d/ /L KIEL/Y Structural plan review fee(or deposit): Contact name: 3,le- t1r-/NC/G e1 / /� G p 7 r (� FLS plan review fee(if applicable): Address: gol 1 /'fll3i T� I Total fees due upon application: � `;? City/State/ZIP: rOieri Mib OR ?7z/i 7 Phone:(503)33/., 91/6 I Fax::( ) Amount received: E-mail: �t r � �; tom Commercial and residential prescriptive installation of s roof-top mounted Photovoltaic Solar Panel System. Business name: % `` Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: Solar Installation Specialty Code checklist. City/State/ZIP: Permit Fee(includes plan review and administrative fees): $180.00 Phone:( ) Fax:( ) State surcharge(12%of permit fee): $21.60 CCB lic.: 00 Ile&3 .1.11‘i l i(„ Total fee due upon application: $201.60 Authorized signature: 2,........--.),,--",e, This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: ®6) /C �/L Date:J'Q�T(Q. /CO *Fee methodology set by Tri-County Building Industry / 7 Seryice Board. I:\Building\Permits\BUP-RESPetmitApp.doc 02/24/2011 440-46131(11/02/COM/WEB) Building Permit Application Checklist One- and Two-Family Dwelling FOR OFFICE USE ONLY City of TigardIII Received Permit No.:DateBY . il 13125 SW Hall Blvd., ard,OR 97223 Associated permits: C Phone: 503.718.2439 Fax: 503.598.1960 24-Hour Inspection Line: 503.639.4175 0 Electrical 0 Plumbing 0 Mechanical 11 G A R D Internet: www.tigard-or.gov ❑ Other: THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW 1e No N/A 1 Land use actions completed. See jurisdiction criteria for concurrent reviews. 0 0 t 2 Zoning. Flood plain,solar balance points,seismic soils designation,historic district,etc. ❑ ❑ 3 Verification of approved plat/lot. ❑ 0 2 4 Fire district approval required. Name of district: • 0 ❑ a 5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ 121 6 Sewer permit. ❑ ❑ '� 7 Water district approval. 0 ❑ Ele 8 Soils report. Must carry original applicable stamp and signature on file or with application. 0 ❑ El 9 Erosion control ❑plan 0 permit required. Include drainage-way protection,silt fence design and location of catch- 0 ❑ g basin protection,etc. 10 3 Complete sets of legible plans. Must be drawn to scale,showing conformance to applicable local and state K 0 ❑ building codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plan location and details. Plan review cannot be completed if copyright violations exist. 11 Site/plot plan drawn to scale. The plan must show lot and building setback dimensions;property corner elevations(if 4 0 0 there is more than a 4-ft.elevation differential,plan must show contour lines at 2-ft.intervals);location of easements and driveway;footprint of structure(including decks);location of wells/septic systems;utility locations;direction indicator;lot area;building coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 12 Foundation plan. Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent size ❑ 0 ❑ and location. 13 Floor plans. Show all dimensions,room identification,window size,location of smoke detectors,water heater, `1Z1 ❑ ❑ furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inches above grade,etc. 14 Cross section(s)and details. Show all framing-member sizes and spacing such as floor beams,headers,joists,sub- ❑ 0 El floor,wall construction,roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and foundation,stairs,fireplace construction,thermal insulation,etc. 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. ❑ 0 ,® Exterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with cross references are acceptable. 16 Wall bracing(prescriptive path)and/or lateral analysis plans. Must indicate details and locations;for non- 0 ❑ EJ prescriptive path analysis provide specifications and calculations to engineering standards. 17 Floor/roof framing. Provide plans for all floors/roof assemblies,indicating member sizing,spacing,and bearing ❑ ❑ Ei locations. Show attic ventilation. 18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered z( ❑ ❑ systems,see item 22,"Engineer's calculations." 19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists El ❑ ❑ over 10 feet long and/or any beam/joist carrying a non-uniform load. 20 Manufactured floor/roof truss design details. ❑ ❑ gf 21 Energy Code compliance. Identify the prescriptive path or provide calculations. A gas-piping schematic is required 0 ❑ IEI for four or more appliances. 22 Engineer's calculations. When required or provided,(i.e.,shear wall,roof truss)shall be stamped by an engineer or g ❑ ❑ architect licensed in Oreton and shall be shown to be a,,licable to the .ro'ect under review. JURISDICTIONAL SPECIFICS 23 Three(3)site plans are required for Item 11 above. Site plans must be 8-1/2"x 11"or 11"x 17". ❑ ❑ ❑ 24 Two(2)sets each are required for Items 16, 19,20 and 22 above. ❑ ❑ 0 25 Building plans shall not contain red lines or tape-ons. "Mirrored"building plans will not be accepted. ❑ ❑ ❑ 26 "Reversed"building plans must meet criteria outlined in the Permit&System Development Fees document. ❑ ❑ ❑ 27 "Drawn to scale"indicates standard architect or engineer scale. 0 0 ❑ 28 Site plan to include tree size,type and location per approved project street tree plan(if applicable),and City of Tigard ❑ ❑ ❑ Street Tree List. 29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations,driplines, ❑ ❑ ❑ and protection measures must be drawn to scale and must include the project arborist's signature of approval. 30 A Clean Water Services'Sensitive Area Pre-Screening Site Assessment form is required for all building additions, ❑ ❑ ❑ including decks,patio covers(over non-impervious surface)and accessory structures to existing residential dwellings on a lot of record approved prior to September 9, 1995. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(11/02/COM/WEB) F RCElVFP „ 4...,4. ._„,..4 Mechanical Permit Application MI(01RL I. s•;.1 IE\I N riCi 18 201b Reeelved City of Tigard Daterny. ,....-- * 13125 SW 11411 Blvd.,'Tigard,OR 97223 ''''' ., . III s - Mao ReNICW Ponta No.fey):57.....kib Other Poona' eci-tr , • a Phone 503 718 2439 Fax c4)3 598 MTV OF TIGARD Dateilly” , _ ,, , , RARE) Inspection Lose 503 639.4175 *. :' Internet VVV,Ve.tigartt-tir gov BUILDING DIVISION' '),Read'Y'''Br See Page 2 sootiettivterhoti- 1,06 el for Supptemental Infortnation •,,-- ,,..; ,-,,,,,, ;;;,,,,_.-,l,„:. TYPE 4i:viro1flt. _ .;',_ ,.:7-?, ,`,,,q r“°:;' ,-.._ -i*, Lited*FfIV$tell.!plit*,:,:—, ..'-',.`-.0i'lllc.flariSf Mechanical permit fees*are based on the value of the work 0 New construction .0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all EJ Demolition 0 Other: mechanical materials,equipment,labor overhead,and profit cATE4,, i,,..viii,ro-Isigititty . ,LON.-.,,,„_,,,., ,,,'. ,„- - ___ ,, , Value:5 - , :. ' li ,: '- '-`-:' " - ' __VIVI-I'MENT,Wi''Al'''''''-til$!$*''''' 0 I-and 2-family dwelling 0 Commerciailindtistrial 0 Accessory building For special information use checklist Ej Multi-Ibmily 0 Master builder 0 Other: Description 1 Qty 1 Ea Total Heating/cooling: JOB SITt-1‘'Ili"KyrioN ow tocArtoat - '- - Air conditioning 46.75 Job site address: a,7 I 7 4914 F no i lahtne. Furnace 1(X)000 Kit(dios,...tb) 46 75 City/State/ZIP; --1140100" 0 . grioo Furnace 100,000-Bilt(ductsiiems) 54.91 Ilmit pump 61 06 Suitethldg.lapt.no.: Project name: H ityl,8, Duct work 23.32 Cross street/directions to job site: li:idromc hot water systein 23 32 Residential boiler(radiator or hydroiik) 23.32 Unit heaters(ftwi-type,not elect;let in-wall,in-duct,suspended,etc. 46 75 Flue/vent for any of above 23.32 Other 23.32 Subdivision: Lot no,: Other fuel appliances: 'fax map/parcel no.: Fater heater 23 32 Gas fireplace/insert 33.39 flue vent for water heater or gas Br i 1 .f.f-A.e CIAACI-1 n et 'LP ace' 23.32 log lighter(gas) 23 32 ., , Oa yeLevi-,44c , ,g, 11 hti Wood/pellet stove 33 39 :, • Wood fireplacOnseit 23.32 Chimney/liner/flue/vent 23.32 23.32 i' ,,.,, ',.':-":"-:';:: ,i:„in iiiryid..4-§or--, ... -- , , -, Other .. . __ , :i•-,'v..:..,,4, ,,l* . , ,,,-****Y'''...-7*"'-' - ' Environmental exhaust and ventilation: Name: Range hood/other kitchen equipment .. 33 39 Address. Clothes:der exhaust 33 39 City/State/11P: Single-duct exhaust(bathrooms, toilet coin is rtments,.mato/rooms) ...1.._ 23 32 }3. ,L Phone:( ) Fax ( ) Attic/crawls ace inns 2132 -ollivr &t-4- t.4 -it i 23 32 ;3 3,1 Fuel piping: BliStneSS name: $14,15 for first four.$4:03 for each additional Contact name: Furnace,etc Gas heat pump Address: . . Wall/suspended/unit heater t 1 ty/Statell I I': Water heater Phone:( ) fax ( ) Fireplace Range E-mail: Barbecue Clothes dryer(gas) ,,,, Business name: pe,: ,,,," 14.."4.141 4 Ai, 1,fi,e1A(1 . Other 17-b '.."',- r40-= R I IT 104 'ilk Le" ,'4 --,,•'',„,i '-'.,--::::-. C4,''-,:l#':•IT-IftS!"„`-' - :-,,;,,,,,-, ,- Address: IGC375 p:)." ii Ave, ,,,,c, ,,.. , Subtotal 6cl. 77 Minimum permit fee(S90 00) Cit)1StatelliP" (4qr.'', 5 ,,-' Plan review(25%of permit foe) Phone:(;03)25: -3243 Fax:( 0 24-3 ..3 2.‘„) State surcharge(12%of permit fee) iC . ..t.) CCB lic.: 1 ,7 0 3 78 TOTAL PERMIT FEE This permit application expires it a permit is not obtained within Ian $ nays after it has been accepted as complete. Authorised signature: iii,, , * Fee methodology set by 1 il-County Rol IdIng Industry Semite Board I f fei, I Print name: geciei. j , A 4... I Date: 10/i 1147 1 (Sul ItIttkg l't:flYtli.,,,,tet reilistoop 0401 I i dm 7 55141 171 i I'i 112 t(Alva in A Electrical Permit Application FOR OFFICE ESE ONE 1 � ' ' ,,pn City O Tigard it t Received IN . PlaPermit#: /Y Z 13125 SW Hall Blvd„Tigard,OR 97223 Plan n Review Phone: 501718.2439 Fax: 503.598.1960DateB Related Permit#: T I C A R D Inspection Line: 503.639.4175 0 C 1 18 2016 Ready Date/By: to see Page z for Internet www.tigard-or.gov Notified/Method: NM L'� Supplemental Iaformshon ',.,e sgoy-,,,ix„ ,,s'." _ N;€ '""s.i ti� 1:**-' �.a` r*y .,-, tet a �t -+` a ik r �r kx r r e:".,�'s � . � f tm �h.�F .�a�°�� q'��n ��+N�*�,� '�� v.. .y.a 1+41F, .z. ,'"-"'7,,:F'417:11; ❑New construction Addition/alt=r r r 1 .i‘,1p ddd 1, 1 N Please check all that apply(submit 1 sets of plans w/items checked): Q Service or feeder 400 maps or more ❑Building over three stories. ❑Demolition 0 Other: :✓ffexceeds available holt current QMarinasar�boatyards.� u_ y r 7,`11'$, 0� ', i?! OeS ° _� � "" 10,0°°snips or,Li Ploat®gbuidings: it: i-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 Q commercial-use agricultural I/ Multi-family Master buildert for all installations. buildings. 0 Other: other �;�y �� ,,� QFtrepump_ ❑Installationofl50ICYAor 'rte t r ,`t a a 4 DEmergeney system. • mo separately derived Job#: Job site address: yy , Qa�ition of new motor mod of mom. i 4=144.) J/mv to Cs, 1..a+tw 10011P or more. '0 ,"E "12","13", City/StateIZIEE': *-1—:"..5c,,,„41. E1 Six or more residential units. y. " Q I3ealth care f °lir as 'lD Beat onai vehicleparks. Su'tte/bldgfaptProject name: [' kY► Cl llarardoas locations Q Simply voltage for more than Cross street/directions1]Service or feeder 600 or 600 volts nominal. to job site:. "'� Newtatios Y residential single-or multi-family dwelling unit. Subdivision: I Lot# Includes attached garage. ; Tax map/parcel#; 1, NAL or less 168.54 4 .....�. ,., Ea.add'I 500 sq.ft.orr 33.92 1` , srt ,'::„:11::,-, a t �. a'' : ,. :�-. ,.. .°a Limited energy,residential 1 .a � .e _ - 1 (with above sq.ft) ?3.00 2 it'll 1 ,nw oy res (with above sq,ti.) :=rai7500 2 t �� t:r .-, Renewable Energy n See Paget v; . nn's- :-. :. Servit sorfeedersInstalllation a i r add/orrelocation Name: Po.' C., kAs..4t"1r 'l. 200 amps or less 10070 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 to 600amps i 300.34 2 601 amps to 1,000 amps 301,04 2 Phone:( ) I Fax:( ) over 1,000 ani or volts 552.26 2 Email: TTemay services or feeders installation,alteration,and/or Owner Installation:This installation is being made on PmPorty that I own which is not 200 amps or less i 5936 , l intended for sale,lease,rent,or exehange,according to ORS 447,449,670,and 701. 201 amps to 400 amps i 125.082 Owner signature: Date: , 401 amps to.599 amps 16834 _ 2 - � Branch eireht►lts--new,alterationtw, tension,IPanel: , ' ' " � : , .Pee for hisltwith Business name: above service arfeeder fee, 7.42 2 Contact name: cads buuach circuit i B.Fee for branch circuits without Address: service or feeder fee,first It56.18,t 2 branch circuit City/State/ZIP: Each addl.branch circuit ki, 7.42 ,: R4,) 2 ( ) ' Mlscellancous(service or feeder ant included) Bach manufactured or modetlar y 6784 2 J Rhone:( ) Fax Email: dwelling,service and/or feeder i Reconnect only a' 't 9• ' p� �� '� Pump or irr mot n cads ' 67.842 22 . ��.�. 67.84 Business name: )t„.1,,. c.. „l c., Sign or outline lighting 67.84 2 Address ' t p�, Signal ciraut(s)or limited-energy Q `* panel,altexation,or extension. See Page 2 2 City/State/ZIP: ( Each additional inspection over allowable in rtny of the above t 4{NN i e Additional.inspection(1 hr thin) 66.25/hr Phone:(So.. ,)6v6a,W g I Fax:(5° ,5%,"a _ l litikk 1nwestigation(l hr min) 90.00/hr Email: Industrial plant(I hrm n) 78.18/1r ( ,so 9— c.. CCB Lic.: Isi 165 Electrical Lic.: 5 Suprv. ie.: %4 inspectionslisoad th hr mut for which no fee is 1 90.001 to Suprv.Electrician signature,required: ? " _. `- Subtotal: 1 .95 Print name: Yorr 0.,tY' 4Q..ii, l Date: 10—1,&....1.6 Q Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): r4t..1 Authorized signature: TOTAL PERMIT FEE: l ..-1,`Z t i� This permit application expires if a permit is not obtained within 180 Print name: Date: L p'�.. days after it has been accepted as complete. *C\Buildi Number of inspections allowed per permit. ag\Permits\ELC Permit .:_ELR ERE,d Rev 06/17/2015 4404615T(1V05/CQMMEB Plumbing Permit Application RECEIVE Budding Fixtures FOR OFFICE USE ()NIAF City of Tigard Received g Date/By: aTt:r Permit No.: ,y1 T)�,r(p._ iii III O l ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review 2 0 ® Phone: 503.718.2439 Fax: 503.598.1960 16 Date/By: Other Permit Na.: Inspection Line: 503.639.4175 , G A i� Ti G A K t� � Date Ready/By: hurls: 0 See Page 2 for Internet: www.tigard or gov Notified/Method: Supplemental Information 1111�i i _ =1 y,jai'hill�'11� 6{'7 A1x�_ '1'.1:.1:1 -_ 1,. 'Nil �.�, 1�� it" n ❑New construction ❑Demolition For special information use checklist - Description I Qty. I Ea. I Total w Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 ft.for each utility connection) ® e s { SFR(1)bath 312.70 ® 1-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78 SFR(3)bath 500.32 ❑Accessory building 0 Multi-family Each additional bath/kitchen 25.02 ❑Master builder 0 Other: Fire sprinkler( sq.ft.) Page 2 r : w .'..'441,...1-1,,P.,'. s Site utilities. Job site address:12797 SW DaVinci Lane Catch basinor area drain 18.76 City/State/ZIP Tigard,OR 97224 Drywell,leach line,or trench drain 18.76 Footing drain(no.linear ft.: ) Page 2 Suite/bldg./apt.no.: l Project name:Huneke Manufactured home utilities 50.03 Cross street/directions to job site: Manholes 18.76 Rain drain connector 18.76 Sanitary sewer(no.linear ft.: ) Page 2 Storm sewer(no.linear ft.:,,,_,,,,) Page 2 Water service(no.linear ft:_) Page 2 Subdivision: I Lot no.: Firtnre or Item: Tax map/parcel no.: Backflow preventer 31.27 Backwater Valve 12.51 M .° Clothes washer 25.02 Remodel Bathroom and Kitchen Dishwasher 25.02 Plumber of Record Drinking fountain 25.02 Ejectors/sump 1 25.02 ); O,i- Bx ansion tank � � � P 12.51 � E Name: Fixtureisewer cap 25.02 Floor drain/floor sink/hub 25.02 Address: Garbage disposal 25.02 City/State/ZIP: Hose bib 25.02 Phone:( ) Fax:( ) Ice maker 12.51 o a Interceptor/grease tra 25.02 Business name: M ical gas(value: ) Page 2 Contact name: Primer 12.51 Roof drain(commercial) 12.51 Address: Sink/basin/lavatory g 2 25.02 t# City/State/ZIP: Solar units(potable water) 62.54 Phone:( ) Fax::( ) Tub/showerlshower pan 1 12.51 „/,4 ..;>. E-mail: Urinal 25.02 Water closet 1 / 25.02 y23-,O,) ° Welter heater' 1 7 37.52 3-2-yam- Business name:Modern Plumbing CO. Water pipng/DWV 56.29 Address:11120 SW Industrial Way,Bldg.9-3 Other: 25.02 City/State/ZIP:Tualatin,OR 97062 Subtotal U /, Phone:(503)691-6166 Fax:(503)691-6771 Minimum permit fee: 572.50 CCB Lic.:87906 Plumbing Lic.no.:34-250PB Plan review (25%of permit fee) State surcharge(12%of permit fee) / O f Authorized signature: 101 TOTAL PERMIT FEE i Print name:Deborah George Date:10/11/16 This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. *Fee methodology set by Tri-County Building Industry Service Board. f:lBuilding\Permits\PLMU-PermitApp.doc 10/01/09 440W616T(10/02/COM/WEB) Mechanical Permit Application FOR OFFICE USE ONLY /It City of Tigard 13125 SW Hall Blvd.,Tigard,OR 97223 " 1 i Phone- 503.718.2439 Fax: 503.598.1960 Lh. ' Inspection. Line: 503.639.4175 Date Ready/By: Juris• See Page 2 for Internet: virv.w.tigard-or.gov Received Date/By: Plan Review Date/By: Other Permit: Notified/Method: Permit No.: El . Supplemental Information • 'Vt-,--6—V*---,.•,' ,".t, ',..,,,ii, statwEllsiv 11'4:'''')'.:-. - '''.....'11- ' ' '''. '7- --- ' " '' of the work - - -- -T '' '41;t's i,„'A,ait.lc ,, ----;-1-'2?n,7 ,.,-,---l.'ili,ilf,d11,3-- ----- Mechanical permit fees are based on the value 1114,111...'"'....3, []New constructionC.4 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all 0 Demolition El Other: mechanical materials,equipment,labor,overhead,and Profit. Value:$ .! -',...-°- - ,'"1'"''1/4,----'71-----'---- '11-1-;±:,';'''''':,,'& ''''--.71''-'7414.7: -.4i±....i.,,,':.:.'l i'41111"-4--.5-'-°,-.Piij,.'-,'A';':V*---fir.--*0-',',1,,,, ,,,,,,, -,,Au. -----' -'' ' r4 1-and 2..f ily dwelling 0 Commercial/industrial 0 Accessory building For special Information use checklist. O 0 Master builderEl Other: Description 1 Qty. I Ea. I Total 0 Multi-family _., Ifeadng/cooling: Furnacem, 100,000 conditioning BTU(ducts/vents) 46.75 46.75 Job site address:12797 SW ritiVinci Lane City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 6L06 Suite/bldg./apt.no.: I Project name: Duct work 2332 Cross street/directions to job site: Hydropic hot water system 23-32 Residential boiler(radiator or hydmnic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: other: 23.32 Other fuel appliances: Tax map/parcel no.: a e W t r heater 23.32 33.39 Flue vent for water heater or gas .firePbtce 23.32 gas piping to water heater Log lighter(gas) 23.32 Gas line installer of record Wood/pellet stovee3339 Wood fireplac lasert 23.32 Chlruney/liner/fluefuein 23.32 -- Other: 23.32 ir---,-- -----75:.-IL.„,10*fit--7;;;,---.1-ap,...4%.71iii- r -"'--2.-1_,..-„,--„- 1::-.11•1 ''''.."'l: NI;:r''',_ ,._ „„- Environmental exhaust ventilation: N39Range hood/other equipment Adandiree:as: Single-duct dryer exhaust st ,.(bathrooms, 33.39toilet compartments,utility rooms) 23.32 CiV/State/ZIP: Fax:( ) Asnanratvispane fans 23,3223,32 $ - - --.4•-ir,‘:-A 14 L.,tet,i6.13- '', : ' - -11, . ,.,-,Lt-:.:,!_-__..........: - - -— Fuel piping: Business name: $14.15 for first four;$4.03 for each additional , Contact name: Furnaceetc. Gas heat pump Address: Wall/suspended/unit heater City/State/ZIP: Water heater 1 Phone:( ) I Fax::( ) Fireplace Range E-mail: Barbecue dc, -4,•;.;;,-y,ifi,,,:-.1fRiFi7,77.174:441.. ::,!:,:r. ss-!--,.,4.4dv, ....,11-31,,z-,'...: 6,:,..t,---,,74itt.::;:t.c...72/..,'R_,,,,i,;Fifft-11,...ii:_,_;i.-1. '.q.4,,...,_::::_-_,-,..,1„,v-,--2-- ',',, -.5...,a4.4L.......1..,--- ...,,,,-•,---- '-* Other: Business name:Modern Plumbing Co. Address:11120 SW Industrial Way,Building 9-3 Minimum permit feeS(su9obto.otiol City/State/ZIP:Tualatin,OR 97062 Plan review(25%of permit fee) Phone:(503)691-6166 Fax.:(503)691-6771 State surcharge(12%of permit fee) CCB lie.:87906 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Authorized signature: IP ' * Fee methodology set by Tri-County Building Industry Service Board Print name:Deborah George Date: 440-4617T(11/02/COMAVEB) I\Building 1 Permits‘MEC PennitApp 040113.doc City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12797 SW DA VINCI LN, TIGARD, OR, 97224 March 1 , 2018 at 9:45:00 AM Record Type: Record ID: Residential - Master Permit MST2016-00416 Inspection Type: Inspector: 699 Mechanical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12797 SW DA VINCI LN, TIGARD, OR, 97224 March 1 , 2018 at 9:46:55 AM Record Type: Record ID: Residential - Master Permit MST2016-00416 Inspection Type: Inspector: 399 Plumbing final David Young Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12797 SW DA VINCI LN, TIGARD, OR, 97224 March 1 , 2018 at 9:51 :39 AM Record Type: Record ID: Residential - Master Permit MST2016-00416 Inspection Type: Inspector: 299 Final inspection David Young Result: PASS - NoCofO Comments: Ladder at egress window well installed. Smoke / carbon monoxide detectors ok in addition and existing house. Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12797 SW DA VINCI LN, TIGARD, OR, 97224 March 1 , 2018 at 9:46:04 AM Record Type: Record ID: Residential - Master Permit MST2016-00416 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS Comments: Violation Summary: Inspector Contractor